Am I Just an Asshole?: The Difference Between Autism and Narcissism and Why it Matters

You’ll have to be really honest with yourself about this one.

Over my short career, I’ve had several patients who were self-diagnosed as autistic or with having Asperger’s Syndrome. They would make rude comments and then excuse them with the diagnosis. So, as you can imagine, most people felt guilty for expressing their resentment. According to the DSM-5, in order to be diagnosed with autism, a patient must present persistent deficits in communication across several contexts; have restricted, repetitive patterns of activities, interests, or behavior; and present with their symptoms at an early age. When you observe the detailed criteria and want to find a reason for your selfishness and rudeness, it’s easy to consider yourself to be autistic and provide yourself with a story that absolves you of any normative responsibility. So, how can we distinguish between Narcissistic Personality Disorder, or NPD (and its counterpart, Borderline Personality Disorder), from Autism Spectrum Disorder?

Initially, I gave those clients the benefit of the doubt and accepted their self-descriptions. But, over time, as I got to know them, I caught a peek into the maliciousness of their self-absorption. The individual with autism doesn’t understand that she’s harming someone, whereas the narcissist doesn’t care and, at worst, aims to do so. If they wish to bring you down to their level and make you feel inferior, they’ll nit-pick and expose your flaws. For them, doing so makes one more malleable and grateful. Sometimes, they’ll put you down just to feel superior if they’re feeling low, but at others, they’ll do it to assert their dominance. An autistic person, on the contrary, is just hyperfocused on herself. The distinction here is between the person who’s often rude and the one who’s often, or at least occasionally, nice. Narcissists are frequently charming until you’re theirs. Then, they flip a switch and find fault with most of what you do. The rudeness of autism, however, is fairly stable and isn’t founded on manipulative intent.

Additionally, narcissists use guilt and punishment to make others feel indebted. Around one, you’ll always feel like you should be doing more. You’ll feel unempathetic, uncaring, and generally not good enough. When you succeed, he’ll make you feel guilty for your success (or simply minimize it), as opposed to someone with autism, who likely won’t acknowledge it. Narcissists tend to feel that others’ achievements are solely due to luck and conceive of themselves as the sole victims of circumstance. They’ll say things like, “If I had it as well as you did, I’d be as successful, too.” And, narcissists blame others for their misery, sensing an inherent unfairness to their lots. Thus, their lack of empathy is more conscious: they choose to fail to consider a world that they believe refuses to consider them. The difference between autism and narcissism, as noted in the article linked below, is that one implies a high degree of non-sensitivity, whereas the other implies one of insensitivity; the former doesn’t know and the latter doesn’t care.

Finally, narcissists require and love external validation (both praise and sympathy). They’ll talk over you; they’ll re-direct a conversation about your sorrows to theirs, noting how they’ve had it worse; and they’ll one-up your accomplishments. Whatever you’re going through isn’t an excuse to garner the attention they’re entitled to. Remember, they’re insensitive and won’t give a shit about your struggles.

Unfortunately, it takes time to get to know a person in order to distinguish between the two disorders. I want to be clear in stating that both are in some form diseases of the brain as well as psychosocial ones. Some narcissists prefer to be labeled autistic because it gives them an excuse for their behavior, therefore reducing the likelihood of blame. Others refuse to accept the NPD label, as it implies a moral failing and, therefore, imperfection. But, both are significant psycho/neurological disorders. I wrote this article not to perpetuate the stigma of NPD, but to help others understand it in order to decide for themselves if they wish to continue to associate with those with it. Narcissists are badly traumatized and need help. But enabling their behavior by feeding into their poorly-ascribed labels is a bad way to provide it.


  1. Well Narcissism can be triggered by PTSD too, as a self defense mechanism to survive. The question is how can an empath turn into a narcissist? 2 steps. Force severe trauma on an empath and then take away their mental emotions and that’s all it takes. The PTSD will trigger flight or fight, but given that the body feels like its being attacked constantly, and other emotions can’t rein that person in, that person is completely toxic and that person is stuck in fight. So it’s that person’s duty to walk back their trauma, tame the body’s reactions, and stop the log jam that’s causing the emotional numbness, and that’s what recovery looks like for said cause of narcissism. I’m sure there’s other causes as well.

    Liked by 1 person

  2. Not too bad but certainly not clear enough. Wrong termonology was used with the words ‘diseases’ and ‘psycho/neurological disorders’ both do not apply to autism. Hopefully there will be much more research on the actually great differences between autism and narcissism.


  3. a person can have both ~ one is neurological the other a form of PTSD
    it is very hard to process wtf just happened having lived with one for 25 years


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